Time in range as a useful marker for evaluating retinal functional changes in diabetic retinopathy patients  

作　　者：Dan-Dan Zhu Xuan Wu Xin-Xuan Cheng Ning Ding 

机构地区：[1]Department of Ophthalmology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210000,Jiangsu Province,China [2]Department of Ophthalmology,Nanjing Drum Tower Hospital Group Suqian Hospital,Suqian 223800,Jiangsu Province,China [3]Department of Nutrition and Food Hygiene,Nanjing University of Chinese Medicine,Nanjing 210000,Jiangsu Province,China

出　　处：《International Journal of Ophthalmology(English edition)》2023年第6期915-920,共6页国际眼科杂志（英文版）

摘　　要：·AIM:To elucidate the relationship between macular sensitivity and time in range(TIR)obtained from continuous glucose monitoring(CGM)measures in diabetic patients with or without diabetic retinopathy(DR).·METHODS:This was a cross-sectional study including 100 eyes of non-DR patients and 60 eyes of DR patients.An advanced microperimetry was used to quantitate the retinal mean sensitivity(MS)and fixation stability in central macula.TIR of 3.9-10.0 mmol/L was evaluated with CGM.Pearson coefficient analysis and multiple linear regression analysis were used to assess the correlation between TIR and retinal sensitivity.·RESULTS:In a comparison of non-DR patients,significant differences(P<0.05)were found in Hb A1c,TIR,coefficient of variation(CV),standard deviation of blood glucose(SDBG)and mean amplitude of glucose excursion(MAGE)values in DR patients.Besides,those DR patients had significantly poor best-corrected visual acuity(BCVA,log MAR,P=0.001).In terms of microperimetry parameters,retinal mean sensitivity(MS)and the percentages of fixation points located within 2°and 4°diameter circles were significantly decreased in the DR group(P<0.001,P<0.001,P=0.02,respectively).The bivariate contour ellipse area(BCEA)encompassing 68.2%,95.4%,99.6%of fixation points were all significantly increased in the DR group(P=0.01,P=0.006,P=0.01,respectively).Correlation analysis showed that MS were significantly correlated with Hb A1c(P=0.01).TIR was positively correlated with MS(r=0.23,P=0.01).SDBG was negatively correlated with MS(r=-0.24,P=0.01)but there was no correlation between CV and MAGE with MS(P>0.05).A multivariable linear regression analysis was performed to prove that TIR and SDBG were both independent risk factors for MS reduction in the DR group.·CONCLUSION:TIR is correlated with retinal MS reduction in DR patients,suggesting a useful option for evaluating DR progression.

关 键 词：diabetic retinopathy time in range MICROPERIMETRY continuous glucose monitoring 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]